January 30, 2014

GUEST POST:This post was written by Avi Giladi, a plastic and reconstructive surgery resident training in health outcomes research, and an avid CrossFitter.

Avi

Last week Kevin Ogar, a competitive athlete, coach, and certified
CrossFit trainer, had an awful accident resulting
in severe spinal cord injury. This
occurred while he was performing a complex Olympic lifting movement, but it was
something he – like many other athletes – had done thousands of times
before. I assume he thought it would go
fine, just like it had all the other times.

As the nature of Kevin’s injury became widespread news, headlines
were also reporting on under-enrollment of young healthy Americans in new health
care plans supported by the Affordable Care Act. The
message in these dueling headlines was unmistakable: even the most fit of
athletes, who seem invincible, are just one accident away from major health
challenges.

Get health insurance so you can protect yourself, which also
helps protect your loved ones and the community around you. New health plans and subsidies available in
all 50 states make coverage possible for millions who could not access
affordable plans just a few months ago. I have a unique perspective on this for the “young invincibles” – people
in their 20s who figure that health care nightmares won’t happen to them – because
I know them. Across my many years of
playing rugby, and now as an avid “crossfitter” logging training hours 5-7 days
a week with similar friends, many of my teammates and training partners are
without health insurance.

I’m fortunate to now have health care coverage through my
job as a resident in plastic and reconstructive surgery; however, that wasn’t
always the case. While in medical school
I needed insurance, but the University plans were more expensive than I could
afford. I spent hours looking for
alternatives, eventually settling on the minimal coverage I could have and
still meet requirements of my school – and protect myself while playing
rugby. This experience helped me understand
some of the tough financial and coverage decisions that many are forced to make
when it comes to affording health care and health insurance. Whether we call healthcare reform the
Affordable Care Act, or “Obamacare”, some of these tough decisions should now be
easier thanks to this law. Plans with varying
levels of coverage and affordable pricing are available.

What we can learn from Kevin Ogar, and many other
unfortunate athletes who have been injured doing something they love, is that
not being covered is too dangerous – and far too costly. I’m
not advocating that anyone still uninsured enrolls in the most expensive plan
with the highest levels of coverage; however, whether you’re involved in rugby,
CrossFit, biking, rock climbing, swimming, challenge races, skiing, running, or
anything else athletic, you are putting yourself at risk. Considering how much time and money we spend
on gear, supplements, clean eating, and training, as post-collegiate athletes
we must also prioritize protecting ourselves, both physically and
financially. I highly doubt any of us
will stop weight training or Olympic lifting after knowing about Kevin Ogar’s
unfortunate accident, and I doubt he would advocate that we quit. However, I hope that this event will motivate
those who remain uninsured to tap available resources and get health insurance
as you continue in your athletic pursuits.

The deadline to enroll via the online exchanges is March 31,
but there is no reason to wait. The benefits of
health insurance go beyond just having coverage. Even if you seek medical attention that isn’t
covered by your health plan, your expenses will still be far lower than those
of the uninsured because your insurance company negotiates the pricing for
you. And should something very
unexpected happen, having insurance will make a big difference in your
financial burden (and resultant family/network stress). Even treatment for more common and often less
severe injuries, like fractures, ligament injuries, and others, can become
costly – especially if surgery is required.

Yes, the rollout of healthcare.gov in October 2013 was a
letdown, but many of the web problems have been fixed. Inexpensive plans are available, through
healthcare.gov or your own state’s health exchanges, and I encourage anyone
still unsure about their health care coverage to research these options. You might even be eligible for financial assistance or subsidies. Enrollment won’t just magically happen, and
the process might take you a bit of time. But, if you can spend hours (or weeks, or even months) trying to reach
new milestones in your training, how can you truly tell yourself that finding a
few hours to understand and acquire health insurance isn’t doable?

Many community organizations are available to help with this
process. Where I live, in Ann Arbor, Michigan,
the Washtenaw Health Initiative has had success working with young adults in
need of health insurance. They also
distribute this very useful pamphlet. There are a growing number of similar resources
across the country. While I know that many
people reading this won’t need to use most of the coverage elements of their
health insurance plan, and rarely – if ever – even see a doctor, you’re
gambling with your future if you remain uninsured.

I have been deeply moved by the outpouring of support for Kevin
Ogar in the week since his injury, and it serves to show the strength of a
community when one of its own is in need. I've read the articles that focus on the
incident, the intensity of competition, and the community that remains devoted
to pushing to the absolute maximum every day. When I show up for training I expect my coach to challenge me in new and
often somewhat painful ways – that’s why I keep coming back. But that intensity comes with risk, the most
serious aspects of which are completely unpredictable. All post-collegiate athletes, regardless of
skill or intensity level, must have health insurance in order to protect
themselves and their futures.

Aviram Giladi, MD, is a recently “retired” rugby player who now spends his athlete time working on improving in his CrossFit training. He is a resident in plastic and reconstructive surgery living in Ann Arbor, Michigan, and is currently also a Master’s student in the Health and Health Care Research program through the Robert Wood Johnson Clinical Scholar’s Program at the University of Michigan. You can reach or follow Avi @theaviram